Social Anxiety/Taijin-Kyofu Scale (SATS): Development and Psychometric Evaluation of a New Instrument

Authors:
  • TITakeshi Inoue
    Takeshi Inoue
  • MHMifumi Hasegawa
    Mifumi Hasegawa
  • YFYutaka Fujii
    Yutaka Fujii
  • YKYuki Kako
    Yuki Kako
  • YNYasuya Nakato
    Yasuya Nakato
  • NHNaoki Hashimoto
    Naoki Hashimoto
  • KIKoki Ito
    Koki Ito
  • TTTeruaki Tanaka
    Teruaki Tanaka
  • SNShin Nakagawa
    Shin Nakagawa
  • IKIchiro Kusumi
    Ichiro Kusumi
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Abstract
Background: Taijin-kyofu (TK), especially the ‘convinced' subtype of TK (c-TK; also known as the ‘offensive' subtype of TK), is described as a Japanese culture-bound syndrome similar to social anxiety disorder (SAD). Recently, in Western countries, the symptoms of c-TK have been investigated in patients with SAD. We developed the Social Anxiety/Taijin-Kyofu Scale (SATS), a 12-item structured clinician-rated instrument designed to rate the severity of TK symptoms, and examined its reliability and validity. Methods: The SATS was administered to 15 patients with c-TK diagnosed using the traditional Japanese TK criteria. Interviews used to score patients' symptoms were recorded on videotape. Additionally, the Clinical Global Impression-Severity Scale (CGI-S) was administered to assess convergent validity. Interrater reliability was assessed on 15 videotaped interviews; the interviews were independently rated by 10 other raters. Test-retest re-liability was assessed on 15 videotaped interviews by the same rater at an interval of more than 4 weeks. Results: The SATS had high internal consistency (Cronbach's α = 0.97) and good interrater reliability (ICC = 0.88-0.93) and test-retest reliability (ICC = 0.94-0.99). The SATS total score correlated with the CGI-S scores (r = 0.77, p < 0.0001). Conclusion: The SATS appears to be a reliable and valid measure of the symptoms of TK.

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